Provider Demographics
NPI:1003993379
Name:FULMER, ROBIN MARION (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARION
Last Name:FULMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129A BYRON ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1809
Mailing Address - Country:US
Mailing Address - Phone:415-425-0824
Mailing Address - Fax:
Practice Address - Street 1:1936 CARLOTTA DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-1358
Practice Address - Country:US
Practice Address - Phone:925-687-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA263851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical